患者护理与信任：医学预科生应该知道什么

Trust is a popular concept cited by medical school hopefuls in their applications or during the med school interview. It’s understandable that aspiring doctors want to show that they have what it takes to earn the trust of patients. We know that trust is a pillar of the patient-doctor relationship.

信任是有望进入医学院的人在他们的申请书中或在医学院的面试中引用的一个流行概念。有抱负的医生想表明他们有能力赢得病人的信任，这一点是可以理解的。我们知道，信任是医患关系的支柱。

Yet while most of us have a broad grasp of what trust is and how it relates to patient care, defining it in concrete terms and understanding how to cultivate it can be more challenging. Developing a more tangible understanding of the concept of trust will allow med school applicants to discuss it more clearly in applications and help them work toward becoming more adept at cultivating it.

然而，虽然我们大多数人对信任是什么以及它与病人护理的关系有一个广泛的了解，但用具体的术语定义它并理解如何培养它可能更具挑战性。对信任的概念有更具体的理解，将使医学院的申请者在申请中更清楚地讨论它，并帮助他们努力成为更善于培养信任的人。

什么是信任？

If you plan to attend medical school, before you read further, think about what trust means to you, especially as it relates to the patient-doctor relationship.

如果你打算上医学院，在你进一步阅读之前，考虑一下信任对你意味着什么，尤其是当它涉及到病人和医生的关系时。

Have you ever had clinical volunteer or shadowing experiences as a premed where you saw trust between the doctor and patient? Or have you ever sought medical care yourself and placed trust in your physician? In these contexts, how would you define trust?

作为医学预科生，你是否有过临床志愿者或实习经历，在那里你看到了医生和病人之间的信任?或者你曾经自己寻求过医疗护理并相信你的医生吗?在这些情况下，您将如何定义信任?

Even among the scholars, there is not consensus on the definition of trust. Michele Ann Carter wrote in a paper: “Trust is the confident belief based on possibly tenuous evidence that others can be believed to act with goodwill.”

即使在学者之间，对信任的定义也没有达成共识。米歇尔·安·卡特(Michele Ann Carter) 在一篇论文中写道:“信任是一种自信的信念，这种信念基于可能很微弱的证据，即可以相信别人是善意的。”

Building on this definition, Mark A. Hall at the Wake Forest University School of Medicine and several colleagues later examined trust in the medical profession in an article about the topic. They wrote that in medicine, trust comes from a place of vulnerability. People who go to a doctor are inherently vulnerable because they are ill or concerned about illness.The writers pointed out that at its core, trust is about a patient in a vulnerable state having a positive, optimistic attitude toward a doctor’s abilities and intentions.

基于这一定义，维克森林大学医学院的马克·a·霍尔(Mark A. Hall)和几位同事后来在一篇关于这一主题的文章中研究了人们对医疗行业的信任。他们写道，在医学领域，信任来自于脆弱的地方。去看医生的人天生就很脆弱，因为他们生病了或担心生病。作者指出，信任的核心是处于脆弱状态的患者对医生的能力和意图持积极乐观的态度。

In an encounter with a physician, the patient is almost less knowledgeable about their illness than the doctor is. As a result, the patient cannot know with absolute certainty that the physician is making an accurate diagnosis or providing the best treatment, or that the physician is acting with goodwill. Yet the patient must place their faith in the doctor in the presence of incomplete evidence, believing that the doctor has the knowledge and goodwill to act in their best interest.

在与医生的会面中，病人对自己疾病的了解几乎总是少于医生。因此，病人不能绝对肯定地知道医生做出了准确的诊断或提供了最好的治疗，或者医生的行为是善意的。然而，在证据不完整的情况下，病人必须相信医生，相信医生有知识和意愿为他们的最佳利益行事。

如何赢得患者的信任？

Though it may seem like a long way away, it’s not too early to cultivate the skills needed to build trust with patients even when you are a premed student. By developing an understanding of how trust is built between a patient and physician, you can begin to hone this skill. In doing so, you will also sound more sophisticated as you discuss this topic in your medical school applications.

虽然这似乎是一个很漫长的道路，但培养并与患者建立信任所需的技能并不早，即使你是一名医学预科学生。通过了解如何在病人和医生之间建立信任，你可以开始磨练这一技能。这样做，你在医学院申请中讨论这个话题时，听起来也会更老练。

There is a body of literature on different approaches that can foster trust between patients and their doctors. The way of communication between doctors and physicians seems to influence how much patients trust them. Arguably, an even more important element of communication is the ability to listen to patients and hear their concerns.

有大量文献介绍了不同的方法，可以促进患者和医生之间的信任。医生沟通的方式似乎会影响病人对他们的信任程度。可以说，沟通的一个更重要的因素是倾听病人的心声，倾听他们的关切。

Honing your communication skills is a great way to establish trust as a future physician. Find methods that afford you the chance to practice communication, such as teaching or tutoring.

作为一名未来的医生，磨练你的沟通技巧是建立信任关系的好方法。找一些能让你练习沟通的机会，比如教学或辅导。

Leadership experience also helps build communication skills. Good leaders have to effectively communicate their vision to the people they lead and inspire them. You can practise engagment with others and build the skills by participating campus clubs, nonprofit organizations or community service projects.

领导经验也有助于培养沟通技巧。优秀的领导者必须有效地将他们的愿景传达给他们所领导的人，并激励他们。通过参加校园俱乐部、非营利组织或社区服务项目，你可以练习与他人交往，进一步培养这些技能。

As you hone such skills, try to also become better at active listening. Clinical volunteer experiences are a great opportunity to interact with patients and learn how to intently listen to understand their needs.

在你磨练这些技能的同时，也要努力变得更善于主动倾听。临床志愿者的经历是一个很好的机会，可以与患者互动，学习如何专注地倾听，以了解他们的需求。

Many times, premed students enter interactions with patients determined to talk to patients to cheer them up. Giving the patient a chance to speak by asking open-ended questions and taking time to listen may be an even more effective way to build a connection and help patients feel cared for.

很多时候，医学预科学生开始与病人互动，决心与病人交谈，让他们高兴起来。问一些开放式的问题，并花时间倾听，给病人一个开口说话的机会，这可能是建立联系、帮助病人感到被关心的更有效的方法。

Taking real interest in patients’ lives and listening to understand their needs is a way to show respect and to uphold their dignity. Though listening may sound like a trivial skill, becoming a truly active listener requires effort and practice.

真正关心病人的生活，倾听他们的需求，是尊重和维护他们尊严的一种方式。尽管倾听听起来像是一项微不足道的技能，但成为一个真正积极的倾听者需要努力和练习。

如何在医学院申请中讨论信任问题

When you talk about building trust with patients in your medical school essays or interviews, think about what the concept means to you , instead of just memorizing the textbook definition. Consider what elements, in your view, are key to building trust. Don’t be afraid to share those elements and delineate clearly what steps you take to earn the trust of others.Also, make sure to draw on your specific experiences in the health care setting or elsewhere that have taught you how to build trusting relationships.

当你在医学院论文或面试中谈到与患者建立信任时，想想这个概念对你意味着什么，而不是死记硬背教科书上的定义。考虑一下，在你看来，哪些因素是建立信任的关键。不要害怕分享这些元素，并清楚地描述你采取了什么步骤来赢得别人的信任。此外，要确保利用你在医疗保健机构或其他地方的特定经验，这些经验教会了你如何建立信任的关系。

During a medical school interview, you may be asked to design a hypothetical situation where you are required to talk a reluctant patient into accepting a recommended treatment, or work with a difficult person to achieve a common goal. In all of these situations, building trust is key, so it’s important to show that you are aware of its importance and delineate exactly how you would go about establishing it with others.

在医学院的面试中，你可能会被要求在一个假设的情况下，你需要说服一个不情愿的病人接受推荐的治疗，或者与一个难以相处的人合作以实现一个共同的目标。在所有这些情况下，建立信任是关键，所以重要的是要表现出你意识到它的重要性，并准确描述你将如何与他人建立信任。

The insight that you show into this topic can make you sound more informed, mature and prepared to embark on a career in medicine. Furthermore, an understanding of the concept of trust will allow you to build consensus with peers as an aspiring physician and enhance your chances of success as a premed and future medical student.

你对这个话题的洞察力可以让你听起来更有见识，更成熟，并为踏上医学生涯做好准备。此外，对信任概念的理解将使你作为一名有抱负的医生与同行建立共识，并增加你作为医学预科和未来医学学生成功的机会。

来源：U.S.News等，图片来源于网络，如侵删

监制：李璨

审核/责任编辑：田江含

记者：刘煜